Diagnosis For Florida: Improving Health Industry Meets Demands Of More Cost-conscious Public

July 1, 1985|By Peter Adams of The Sentinel Staff

Imagine an industry in Central Florida that employs more people than the region's hotels and had a budget of almost a billion dollars last year.

Central Florida hotels employ about 30,000 people, according to University of Florida statistics. But the health-care industry -- including hospitals, physicians, dentists, nurses, fitness workers, chiropractors, pharmacists, physical therapists and employees of health insurance companies -- account for close to 35,000 jobs.

Central Florida's six counties -- Orange, Osceola, Seminole, Brevard, Volusia and Lake -- are home to 3,713 private-practice physicians, dentists and dental hygienists. Almost 6,000 Central Floridians work in physicians' offices in some capacity.

Central Florida's 28 hospitals employ 20,000 people from administrator to bottle washer and those hospitals, both profit and not-for-profit, spend about $665 million a year, according to figures supplied by the Florida Hospital Association.

Add to that the area's 4,500 pharmacists, lab personnel, physical and occupational therapists and the thousands of people who drive the trucks and make the deliveries that support the Central Florida health industry.

Hospitals alone paid out more than $325 million in salaries in 1983 and, if national averages apply, 10 percent of the value of the goods and services produced in Central Florida is spent on health care.

Central Florida's health industry promises to get bigger as the baby boomers -- the country's largest population segment -- reach retirement age in the next century.

While no economist would venture to put an exact dollar value on the economic impact of health-related industries in Central Florida, several agreed that health expenditures would account for close to $1 billion every year.

Economist Hank Fishkind of M.G. Lewis Econometrics in Winter Park said the reason health care is such an economic gargantuan is ''because we demand a lot.''

It's tough to spend that much money on anything without drawing a lot of attention, and along with that scrutiny will come some criticism.

Some observers of the nation's health-care system, such as Victor Sidel, professor of Medicine at Albert Einstein College of Medicine in New York City, believe spending too often is for multimillion dollar pieces of equipment that may make a particular hospital competitive, but do little to address health problems of the poor.

While Americans demand the best in medical care and pay handsomely for it, many are spending money to avoid health-care expenses. Almost 8 million Americans practice preventive medicine and join health clubs to stay fit. In Central Florida alone, there are dozens of health and fitness clubs.

Health-care costs grew by 11 percent in 1982 while the Consumer Price Index, a measure of the cost of living, went up by 4 percent. But the health- care increase slowed to 8 percent between 1984 and 1985, according to the U.S Health and Human Services Department.

While the health-care costs are still exceeding the rise in the CPI, there are hopeful signs for health-care consumers.

Some state governments, such as Florida's, have set up cost containment boards that regulate hospital budgets and provide consumers with shopping lists that compare hospital prices. Since 1983, the federal government has reimbursed hospitals on a set fee for certain procedures under Medicare, forcing hospitals to operate more efficiently.

Businesses are no longer content to pay any price for their employees' medical care. Today, they are shopping for plans that combine medical care and insurance in structures called Health Maintenance Organizations and Preferred Provider Organizations.

Under the HMOs and PPOs, consumers are offered a savings by getting their medical care from a clinic or a from a list of doctors that participate in the program.

In Central Florida, 295 companies participate in one of three major HMOs. And later this year Blue Cross/Blue Shield of Florida will get into the fray, competing for a share of the group health-plan dollar.

Neither are insurance companies any longer content to pay the big bill on health care. They are shifting more of the burden onto the consumer. Contributory plans, for example, require the patient to pay a portion of the cost of family coverage.

Dentists, eye specialists and private practitioner MDs are all finding themselves competing for the health-care pie with higher-volume group practices and clinics that can offer medical services less expensively.